AMA physician-employment guidelines put patient needs first

With implementation of the Affordable Care Act expected to further drive healthcare consolidation and physician employment, the American Medical Association has put forth six guiding principles to protect patient and physician interests in employment arrangements. These principles cover conflicts of interest, patient advocacy, contracting, hospital-medical staff relations, peer review and performance evaluations and payment agreements.

Overall, these guidelines call for patient care to trump the needs or desires of an employer organization whenever the two come into conflict. For example, the document states that physicians must make treatment and referral decisions based on the best interests of their patients, and employers and the physicians they employ must ensure that agreements influencing particular treatment or referral options are disclosed to patients.

The AMA also wants to ensure that physicians' avoid the pitfalls of unclear or misunderstood employment contracts that some doctors have experienced so far. For instance, the AMA states that, "when a physician's compensation is related to the revenue he or she generates or to similar factors, the employer should make it clear to the physician of the factors upon which compensation is based."

In addition, the AMA puts forth that "employed physicians who are members of the organized medical staff should be free to exercise their personal and professional judgment in voting, speaking and advocating on any matter regarding medical staff matters," according to the document.

"The 'Principles for Physician Employment' provide a broad framework to help guide physicians and their employers as they collaborate to provide safe, high-quality and cost-effective patient care," AMA board member Joseph P. Annis said in a statement. "The guidelines reinforce that patients' welfare must take priority in any situation where the interests of physicians and employers conflict."